Osteoarthritis of the shoulder joint

One third of all elderly people over sixty years of age report pain in the shoulder joint. The cause of pain in this area in most cases is the development of arthrosis. The disease also affects young people, whose profession includes continuous heavy physical activity - miners, builders, porters, etc.

The disease causes great inconvenience in everyday life and significantly reduces the ability to work. In severe cases, shoulder arthrosis leads to disability. It is important to identify the disease in the initial stages. Now there are treatment methods that suppress the progression of the disease when therapy is started at the right time.

What is pathology

Osteoarthritis of the shoulder joint is a chronic disease in which degenerative processes destroy and thin the cartilage. Osteoarthritis of the shoulder is classified as a group of pathologies of a non-infectious nature. First, the cartilage tissue covering the articular surfaces is destroyed.

Cartilage loses its strength and elasticity. It gradually thins and flattens. Due to changes in the cartilage layer, it loses its absorbent qualities. Its ability to reduce shock loads that occur during arm flexion or extension is impaired.

Osteoarthritis also affects all structures, such as the joint capsule, its shell, bone surfaces adjacent to the cartilage layer, ligaments and adjacent muscles. This is accompanied by pathological changes in other soft tissues located near the joint. As a result of the disease, bone growths are formed on the articular surfaces.

The pathology is manifested by pain and tingling in the area of the affected shoulder. In the later stages of the disease, the range of motion in the shoulder joint is significantly reduced. Inflammation in it with this nature of the process is either absent or weakly expressed. The pathology has a chronic course, gradually progressive.

Causes

The cascade of pathological changes in osteoarthritis is triggered by natural tissue aging. Cartilage damage as a result of strong mechanical stress can contribute to the initiation of cartilage destruction. This is also facilitated by various pathological processes.

Primary shoulder arthrosis is usually diagnosed in older people. Secondary joint damage develops against the background of previous diseases. It happens at any age. The main causes of the disease are considered:

1. Developmental abnormalities. The pathology is often found in patients with underdevelopment of the humeral head or glenoid cavity, as well as the presence of other defects of the upper limbs.
2. INJURY. Traumatic arthrosis often develops after intra-articular fractures. Sometimes the cause of the pathology is a displacement of the shoulders, more often a common one. Occasionally, severe bruising provokes the development of pathology.
3. Inflammation. Osteoarthritis often occurs when a patient suffers from glenohumeral periarthritis for a long time. This is also facilitated by previously suffered non-specific purulent arthritis, as well as specific joint lesions arising due to tuberculosis, syphilis and other diseases.

There is a group of risk factors that contribute to the occurrence of such a polyetiological disease. The following phenomena increase the possibility of developing arthrosis:

• Genetic predisposition. Relatives of many patients also suffer from arthrosis. They also have lesions with other locations. Usually the knee, ankle and other joints are affected.
• overcurrent. It often occurs in athletes involved in volleyball, tennis, basketball and throwing sports equipment. This condition also appears in people if their profession is characterized by a continuous high load on the upper limbs (loaders, miners and others).
• Diseases. Osteoarthritis often develops in patients suffering from autoimmune joint disease. Some endocrine diseases, metabolic disorders and connective tissue insufficiency, which is characterized by excessive joint mobility, also contribute to degenerative processes in cartilage.

The incidence of degenerative articular lesions in patients increases significantly with age. Frequent hypothermia also negatively affects the joints.

Symptoms

At the beginning of the disease, patients with arthrosis experience a feeling of discomfort and moderate pain in the shoulder area. There is a dependence of pain on the weather. They become more intense after physical activity. The pain intensifies in a certain position of the body. After resting or changing the position, the pain disappears.

When the patient moves the hand, a tingling sensation appears. There are no external changes in the joint, no swelling. Over time, the pain becomes stronger. It constantly disturbs the patient, regardless of the position of the body. The pain has a pulling or aching character.

Pain in the shoulder joint becomes common and constant. Painful sensations appear both during exercise and at rest. They can disturb the patient at night. The characteristic features of the pain syndrome in joint osteoarthritis are as follows:

• along with the appearance of aching pain over time, sharp pains occur during physical activity;
• unpleasant sensations are registered only in the wrist area, radiates to the elbow area and can then spread to the entire surface of the arm;
• The pain may spread throughout the back and neck on the affected side.

After a short time, the patient is bothered by morning stiffness in the shoulder. The range of active movements in the joints decreases. After physical activity, as well as hypothermia, slight swelling of the soft tissues in the shoulder area is detected.

As joint damage progresses, there is an increase in range of motion limitations. The patient develops contracture (stiffness), which significantly impairs the functioning of the limb. If the osteoarthritis is on the right side, the patient cannot take care of himself.

Stages of development

With this disease, there are three stages of the pathological process in the joint. They reflect the severity of damage to the articular structures and the presence of certain symptoms of damage to the shoulder joint. Experts distinguish the following stages of the pathological process:

1. First. The absence of major structural changes in the thickness of the cartilage tissue is noted. The composition of the intra-articular fluid varies. Cartilage nutrition is interrupted. He does not tolerate stress well, which leads to periodic pain.
2. Secondly. At this stage, thinning of the cartilage tissue occurs. Its structure is changing. The surface becomes rough. Cysts are formed in the thickness of the cartilaginous layer and foci of calcification appear. Bone areas adjacent to the joint are moderately deformed. The edges of the articular platform are covered with bone growth. The discomfort becomes constant.
3. Third. A pronounced degree of thinning of the cartilaginous layer and destruction of its structure is observed. Extensive areas of cartilage destruction have been identified. A significant deformation of the articular platform is found. Range of motion limitation is detected. There is weakness of the ligaments, as well as a decrease in the size and weakness of the periarticular muscles.

This approach to the classification of shoulder joint lesions allows doctors to choose the appropriate treatment tactics that take into account the severity of the pathological process.

Diagnosing

The appearance of symptoms of arthrosis forces the patient to go to the doctor. He should see a therapist. The specialist will make an initial diagnosis. After determining the cause of joint damage, he will refer the patient to a rheumatologist, endocrinologist, surgeon or orthopedic traumatologist.

Doctors make the diagnosis in the presence of typical clinical manifestations and X-ray signs of arthrosis. During the initial examination, the joint tissues are felt to determine the degree of pain.

The possibility of performing active and passive movements in the affected area is being studied. The doctor detects the deformation of the joint or the increase in its volume. To confirm the presence of arthrosis, the following studies are recommended:

1. X-rays. The presence of dystrophic changes in the cartilage layer is detected in the joint. Characteristic bone growths are identified along the edge of the articular cavity. At a later stage, they find that the shared space has narrowed. A change in the shape and structure of the bone adjacent to the cartilage is defined. The shape of the common space becomes wedge-shaped. In the thickness of the bone, signs of thinning and the presence of cyst-like formations are visible.
2. CT scan. This study in the initial stages of the disease offers an opportunity to assess the condition of bones and cartilage using layer-by-layer imaging.
3. Magnetic resonance imaging. The method assesses the condition of soft tissue formations (cartilage, ligaments, joint capsule, etc. ). Clear layer-by-layer images help determine the extent of damage to articular and periarticular structures.
4. Ultrasonography. Changes in the joints are detected using ultrasound. The method is safe for the body, as there is no harmful radiation.
5. Arthroscopy. It is performed using an endoscope. A manipulator with a camera is inserted into the joint. The doctor clearly sees the damage areas. Areas of softening in cartilage thickness are determined. It reveals the presence of deep cracks that penetrate deep into the subchondral (subchondral) plate of the bone. Deep cartilage ulcers, erosion and superficial cracks are detected.

The diagnosis of arthrosis of the shoulder joint in the later stages does not present any difficulties for doctors. When assessing the nature of joint damage, it is necessary to take into account the possible secondary origin of joint pathology against the background of other diseases.

Treatment

Osteoarthritis treatment is performed by orthopedic traumatologists or rheumatologists. In the phase of restoration of motor functions, rehabilitation specialists take an active part in the treatment process.

To relieve pain and restore function in case of arthrosis of the limbs, it is important to get immediate medical attention and follow all the doctor's orders. It is necessary to limit the load on the joints and avoid sudden movements of the hand. It is important to avoid lifting or carrying heavy objects for long periods of time.

This joint needs a dosed load under the supervision of specialists, as complete inactivity has a negative impact on the affected limb. Treatment options include conservative therapy and surgical intervention. The choice of methods depends on the prevalence of certain symptoms and the stage of the disease.

Drug therapy

An important goal in the treatment of arthrosis is the elimination of pain. To eliminate discomfort and reduce the severity of inflammation, the following medications are prescribed:

1. Preparations for general anesthesia. Non-steroidal drugs are prescribed to patients for a short course during an exacerbation. With prolonged uncontrolled use, they irritate the gastric mucosa and slow down the recovery process in the joints.
2. Local remedies. Gels and ointments containing non-steroidal anti-inflammatory compounds are used when symptoms increase. Medicines containing locally acting hormones are used less often. They relieve inflammation and swelling.
3. Means for intra-articular injections. For persistent and severe pain that cannot be eliminated by other means, glucocorticoid drugs are injected into the joint. Blockades can be carried out no more than four times a year.

In the first and second stages, chondroprotectors are prescribed to restore and strengthen the joint. These products contain chondroitin sulfate, hyaluronic acid and glucosamine. They are used in long courses of six months or more. The effect of the therapy becomes visible only after three months of continuous use of the drug.

In addition, vasodilators are used for shoulder arthrosis. They increase blood circulation and relieve capillary spasms. Muscle relaxants are prescribed to relax the muscles in the shoulder area when spasms are detected.

Surgical methods

In the third stage of arthrosis, when there is a significant destruction of the joint with limited movement and loss of ability to work, endoprosthetic surgery is performed. Age, level of physical activity and general health are taken into account before deciding whether to have an intervention.

Installation of modern ceramic, plastic and metal endoprostheses fully restores joint function. The equipment has a guaranteed service life of more than fifteen years.

Non-drug treatment

Physiotherapy techniques are actively used in the phase of reducing the deterioration in the treatment of osteoarthritis of the joints. Their use of the course gives good results when included in a complex therapy program. For arthrosis, the following physiotherapeutic methods are used:

1. Amplipulse. The treatment method affects the joint locally using alternating electric current. It relieves pain and has a vasodilating effect. The procedure improves tissue nutrition.
2. UHF. The link is exposed to ultra high frequency waves. The method reduces pain, relieves inflammation and swelling.
3. Magnetotherapy. Joint structures are affected by a pulsed magnetic field. Improves blood circulation. Cartilage is packed with nutrients. The magnet removes decay products from the cells. It suppresses autoimmune reactions.
4. Electrophoresis. This technique promotes the penetration of drugs into the affected joint, which is provided by the effect of electric current on the tissue. During the treatment, blood flow to the joint structures increases. The procedure reduces inflammation and swelling. Unpleasant sensations in the hand are relieved. Muscle spasm is eliminated.
5. Balneotherapy. Therapeutic baths with radon, salt and other useful solutions are actively used for shoulder arthrosis. Blood flow improves, which improves nutrition and accelerates cell recovery. Inflammation is relieved.
6. Electrical stimulation. With this treatment method, electrical stimulation of nerve trunks and muscles is performed using electrodes, which transmit a current that has certain parameters.

Therapeutic massage is performed after the relief of irritation. It restores blood circulation and increases the elasticity of ligaments. Muscle spasm in the joint is reduced. Range of motion increases. For arthrosis, exercise therapy is beneficial.

The gymnastics complex is performed when the pain subsides. During mechanotherapy, special simulators are used for rehabilitation. Active-passive movements are performed on them. They restore the function of the affected joint.

How to treat at home?

Laser therapy is considered an effective method in the treatment of shoulder arthrosis. The laser beam has a beneficial effect on the affected joint tissue. Devices that produce low-intensity infrared laser beams are used for therapy. Laser therapy is prescribed to accelerate cell metabolism.

All physico-chemical reactions are stimulated in tissues. Cartilage cell functions are activated. Laser treatment provides an analgesic effect. Blood flow improves and swelling is eliminated. Local immunity is increased. Reserve capillaries dilate. Laser therapy has an anti-inflammatory effect.

To receive the procedures, you do not have to constantly visit a medical institution. Treatment of shoulder arthrosis at home is carried out using portable laser therapy equipment. With their regular use, the pain decreases. Shoulder joint function improves with laser treatment of osteoarthritis at home.

Prognosis and prevention

Shoulder arthrosis cannot be completely cured. But it is possible to slow down the progress of pathological joint changes. With regular treatment, the ability to work is maintained. It is important to follow the doctor's recommendations.

It is necessary to prevent injury to the hand. It is important to avoid excessive impact on the shoulder joint during professional tasks as well as during sports. It is necessary to immediately treat diseases that contribute to the development of arthrosis.